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Front 1

Fetal Assessment During Labor: Decelerations (Basic Concept, RM MN RN 8.0 Chp 13)

Home Safety: Protecting the Client from Injury (Basic Concept, RM Fundamentals 7.0 Chp 13)

Back 1

Fetus must be assessed during contractions. There are three types of FHR patterns. Early decelerations can be caused by compression of the fetal head and no intervention is required. Late decelerations of the fetal heart rate include utero placental insufficiency, maternal hypotension, Abruptio placentae, uterine hyperstimulation with Pitocin, treatment includes change to the sideline position, IV line, DC Pitocin, 02 8 to 10 l. variable deceleration of fetal heart rate includes umbilical cord pression, prolapsed cord, nuchal cord, and Oligohydramnios, treatment includes changing the clients position, DC oxytocin, oxygen

Front 2

Medical Conditions: Second Trimester Complications (RM MN RN 8.0 Chp 9, System Disorder)

Back 2

there are many medical conditions that can occur during pregnancy. Incomplete cervix is the inability of the cervix to support the weight pressure of the growing fetus resulting in expulsion. hyperemesis gravidarum is chronic vomiting that can cause weight loss, electrolyte imbalance, acetonurea, and ketosis. Iron deficiency anemia occurs from lack of iron which causes lowered counts of red blood cells. Gestational diabetes mellitus occurs because of the placenta releasing hormones increasing the resistance of insulin

Front 3

Newborn Assessment: Apgar Scoring (Nursing Skill, RM MN RN 8.0 Chp 23)

Back 3

Apgar score is a scoring system that shows the amount of physical ability that a child has that can rule out abnormalities. And Apgar score of 0 to 3 indicates severe distress, 4 to 6 moderate distress, and 7 to 10 indicates no stress. These scores are based on heart rate, respiratory rate, Muscle tone, reflex irritability, and color. each of these are ranked from zero being absent, to 2 being excellent, one being in the middle

Front 4

Newborn Nutrition: Evaluating Client Understanding (Basic Concept, RM MN RN 8.0 Chp 25)

Back 4

newborn nutrition is very important. Most newborns lose 5 to 10% of body weight right after birth however they regain it 10-14 days. If bottlefeeding the infant is the fed every 3 to 4 hours, every four hours During the night. Breast-feeding is the best source of calories for the baby.

Front 5

Nursing Care of the Newborn: Expected Standard for Assessment and Care (Nursing Skill, RM MN RN 8.0 Chp 24)

Back 5

the physical assessment includes vitals at birth and every 30 min. times two, every hour times two, and then every eight hours. The offense weight is checked daily and the baby should be measured upon delivery worsen after. Metabolic tests should be done within 24 hours and if the patient leaves prior to this testing the test is repeated within one to two weeks

Front 6

Postpartum Disorders: Use of Oxytocin (RM MN RN 8.0 Chp 20, System Disorder)

Back 6

postpartum hemorrhage is a hemorrhage that is caused by delivery and is equal to 500 mL Or more of blood with a vaginal delivery, and over 1000 mL blood loss with cesarean delivery. There things the nurse needs to do if the patient has hemorrhage and these include vital signs find source of bleeding (Fundus assessment), assess bladder for distention IV fluids, oxygen, Elevate client's legs 20 to 30°, And oxytocin,

Front 7

Postpartum Physiological Adaptations: Immediate Postoperative Assessment (Nursing Skill, RM MN RN 8.0 Chp 17)

Continuity of Care: Discharging Newborns (Basic Concept, RM MN RN 8.0 Chp 17)

Back 7

after delivery many physiological changes occur. Pitocin is excreted Which improves contractions thereby decreasing excessive bleeding and hemorrhage. This also causes after pains. Lactation also occurs increasing breastmilk. During this time the mother should be assessed and one acronym is bubble vt, breasts, uterus, bowel, bladder, Lochia, Episiotomy, vital signs, and teaching needs. at this time the fundus Needs to be assessed, as well as The amount of blood output.

Front 8

Prenatal Care: Antepartal Reportable Findings (RM MN RN 8.0 Chp 4, System Disorder)

Back 8

There are many changes that can be positive and negative during pregnancy. Nausea and vomiting occurred normally during the first trimester, breast tenderness, urinary tract infections are common, fatigue may occur, heartburn, constipation, hemorrhoids: backache, shortness of breath, Braxton Hicks contractions as well as supine hypotension Are normal signs.However some signs can be dangerous and these include fluid from the vagina, bleeding, abdominal pain, changes in federal activity, excessive vomiting, severe headache, elevated temperature blurred vision, then of the face and hands, epigastric pain and hypoglycemia

Front 9

Nonpharmacologic Pain Management: Effleurage (Basic Concept, RM MN RN 8.0 Chp 10)

Back 9

preterm labor occurs between 20 and 37 weeks gestation. There are many things that can cause preterm labor and a few from include infection, previous preterm birth, and multi-fetal pregnancy to name a few. There are certain medications that can holds or restrict preterm labor such as terbutaline and magnesium sulfate. The nurse should monitor for respiratory distress and lack of deep tendon reflexes. Pharmacological and nonpharmacological medications can be used to treat pain. Gentle rubbing Of the stomach or Effleurage helps relieve pain

Front 10

Pain Management: Evaluating Breathing Techniques (Basic Concept, RM MN RN 8.0 Chp 12)

Back 10

there are many sources of pain during labor and during the different stages of labor they can cause different sign symptoms of pain. The first stage is caused by dilation and stretching and cervix, and contractions. During the second stage the pain occurs from the fetal head the sending and is often described as burning splitting and tearing. The third stage is increased pain from uterine contractions in pressure point of the pelvic structures. In the fourth stage is caused by Distention and stretching Fetus his head occurring on vagina. During this time pain is be assessed and symptoms include increased blood pressure, tachycardia, and hyperventilation. Hyperventilation may cause the nurse to evaluate the breathing technique of the patient to prevent hyperventilation.

Front 11

Pain Management: Complications of Epidural Anesthetic (RM MN RN 8.0 Chp 10, Therapeutic Procedure)

Back 11

preterm labor occurs between 20 and 37 weeks gestation. There are many things that can cause preterm labor and a few from include infection, previous preterm birth, and multi-fetal pregnancy to name a few. There are certain medications that can holds or restrict preterm labor such as terbutaline and magnesium sulfate. The nurse should monitor for respiratory distress and lack of deep tendon reflexes. Pharmacological and nonpharmacological medications can be used to treat pain. Gentle rubbing Of the stomach or Effleurage helps relieve pain

Front 12

Nonstress Test: Interpreting Results (Diagnostic Procedure, RM MN RN 8.0 Chp 7)

Back 12

nonstress test can be used to determine any type of abnormalities in the fetus. This section covers different types of abnormal bleeding during pregnancy. First semester bleeding can be caused by spontaneous abortion and at ectopic pregnancy. During the second trimester molar pregnancy can occur causing bleeding. And during the third trimester placenta previa, abruptio placenta, and vassa previa.

Front 13

Assessment and Management of Newborn Complications: Neonatal sepsis findings (RM MN RN 8.0 Chp 27, System
Disorder)

Back 13

There are a huge number of assessments that need to be done on newborns. One of the ones that is treated immediately after birth is hypoglycemia.This is anything less than 40 MG per DL. Large for gestational age babies need be assessed routinely. Respiratory distress syndrome is an occurrence and babies that did not have enough surfactant To keep the Alveoli from collapsing. This occurs in babies that are small and large. Neonatal infection is evidenced by temperature instability, Poor feeding, vomiting, Poor weight gain, abdominal distention, Irritability, and poor muscle tone

Front 14

Newborn Assessment: Findings to Report (RM MH RN 8.0 Chp 23, System Disorder)

Back 14

a head to toe assessment is performed shortly after delivery. There are some things and maybe reported to the physician if they are Seen. If the baby doesn't have appropriate reflexes, abnormal lab values, abnormal spots such as infection, and any abnormal growth developments.

Front 15

Complications of Pregnancy: Hypoglycemia (RM MN RN 8.0 Chp 8, System Disorder)

Back 15

offense can have infections Or complications upon delivery. Some of these include HIV, a mother with HIV should not breast-feed the baby. Chlamydia and gonorrhea are sexual transmitted diseases that can be given to the baby. Russian section can be caused by recent antibiotic treatment. Torch infections are a group of infection that can affect the woman is pregnant and these include toxoplasmosis, rubella, cytomegalovirus, and herpes simplex

Front 16

Complications Related to the Labor Process: Prolapsed Cord Nursing Actions (RM MN RN 8.0 Chp 16, System Disorder)

Back 16

prolapsed umbilicus cord is where the court is outside of the uterus or protruding through the cervix. This can cause lack of oxygen to the baby and fetal demise. The the nurse should insert two fingers into the vagina and keep pressure off of theumbilical cord, reposition the client and the knee chest position, apply sterile saline soaked towels to the cord and then administer oxygen.

Front 17

Hyperbilirubinemia: Priority Precaution During Phototherapy (RM MN RN 8.0 Chp 23, System Disorder)

Back 17

newborn assessment is very meticulous throughout the newborns stay. The Apgar score is used immediately and at 5 min. later to assess the baby. Vitals are done routinely in the baby is measured And weighed. The baby can be very the hydrated during light therapy for elevated bilirubin levels and the baby needs to be assessed for dehydration with routine feedings to keep hydrated.

Front 18

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Back 18

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Front 19

Health Promotion of the School-Age Child: Developmental Needs (Growth and Development, RM NCC RN 8.0 Chp 6)

Back 19

This is a time of change for school age children. during this time physical changes take place as well was cognitive. At this age competitive and cooperative play is predominant. The needs of children of this age include immunizations, health screenings, nutrition, dental health, and injury prevention.during this stage they are in the industry versus inferiority. At this age they want to succeed

Front 20

Acute Infectious Gastrointestinal Disorders: Risk Factors Associated with Hepatitis A (RM NCC RN 8.0 Chp 22, System
Disorder)

Back 20

acute infectious gastrointestinal disorders are common in children because of the closeness and the lack of hand hygiene. one common sign of intestinal disorder is diarrhea. The child must be assessed for dehydration routinely. Watch for pale skin, cool lips, dry mucous membranes, decrease Skin terger, diminished urinary output, concentrate urine, thirst, rapid pulse, sunken Fontanelle's, and decrease blood pressure

Front 21

Death and Dying: Parental Decision-Making (Basic Concept, RM NCC RN 8.0 Chp 11)

Back 21

the effect of death and dying on the patient will depend on age. Infants and toddlers and will have little to no effect, preschoolers may feel that they caused it and feel guilty, and from ages six and up they will come to understand the concepts of death. The decision making on care of the dying should be the family's wishes. However the nurse needs to be upfront and honest on possibilities.

Front 22

Burns: Self-Esteem (Growth and Development, RM NCC RN 8.0 Chp 32)

Back 22

there are several ways that humans can become burned, these include thermal, chemical, electrical, and radioactive agents. The degree of burn ranges from superficial, superficial partial thickness, the partial thickness, full thickness, and deep full thickness. During burn management is critical to watch for electrolyte imbalances, excessive pain, infection, and decreased nutrition. If the burn site is to any part of the airway special attention is needed for that as well. School age children may need to participate in the healing process.

Front 23

Pain Management: Nonpharmacological Management of Breakthrough Pain (RM NCC RN 8.0 Chp 9, System Disorder)

Back 23

pain in children needs to be monitored sufficiently as well as evaluated in a timely manner after the medication has been given. The nurse also means the process for adverse reaction to the pain medication itself. The nurse may need to adjust the pain rating scale penning on the age of the client. There are several nonpharmacological measures that can be used to treat pain such as maintaining, environment, eyes to the affected area, and distraction such as video games and music.

Front 24

Cardiovascular Disorders: Toxic Effects of Medications (Medication, RM NCC RN 8.0 Chp 20)

Cardiovascular Disorders: Cardiac Catheterization (Diagnostic Procedure, RM NCC RN 8.0 Chp 20)

Cardiovascular Disorders: Rheumatic Fever (System Disorder, RM NCC RN 8.0 Chp 20)

Back 24

This chapter covers congenital heart disease, anatomic abnormalities, and rheumatic fever that can result in heart disease. There are several risk factors for developing these complications, including rubella, alcohol assumption during pregnancy, diabetes mellitus, familial congenital heart disease, down syndrome, or other congenital anomalies. Cardiac catheterization is an invasive test that can be used to diagnose, repair, and evaluate Arrhythmias. Prior to administration the nurse needs to check for allergies for iodine shellfish. In the event of excessive bleeding Put pressure above the site to decrease bleeding and alert the physician. Rheumatic fever is caused by an inflammatory disease. It is treated with antibiotics that may need to be continued monthly.

Front 25

Safe Administration of Medication: Calculating Daily Divided Dose (Medication, RM NCC RN 8.0 Chp 8)

Safe Administration of Medication: Appropriate Administration of IM Medication (Nursing Skill, RM NCC RN 8.0 Chp 8)

Back 25

Safe medication administration includes the six rights. These include PTR and the three D's, patient time route dose drug and documentation. The nurse also needs to be aware of split dosages such as 80 mg per kilogram per day given to different times.

Front 26

Diabetes Mellitus: Medication Administration (Medication, RM NCC RN 8.0 Chp 33)

Back 26

with diabetes mellitus the patient is at risk especially for hypo and hyperglycemia. Hypoglycemia can be diagnosed with the patient showing signs of hunger, nausea, anxiety, pale skin, and diaphoresis. Hyperglycemia shows signs of thirst, frequent urination, hunger, skin warm and dry. The levels of sugar In the blood can be measured with an A-1 C test. Normal ranges are from 4 to 6%, but may be as high as 6.5 to a percent in children with diabetes. The nurse must know the peak times of medications to give insulin because these times are important for hypoglycemic events.

Front 27

Oxygen and Inhalation Therapy: Pulse Oximetry (Diagnostic Procedure, RM NCC RN 8.0 Chp 16)

Back 27

oxygen therapy is used to treat many different respiratory problems along with other forms of treatment. Pulse oximetry is used to determine the effectiveness of these therapies or to establish a baseline. It works by sending a wave of infrared light measuring how much is absorbed by oxygen and deoxygenated hemoglobin. The nurse needs to know that the sensor may be placed on different sites depending on the Age of the client. at the age range were the child may remove the sensor it can be placed on the big toe. The ideal oxygen saturation is between 95 to 100%

Front 28

Gastrointestinal Structural and Inflammatory Disorders: Nephrotic Syndrome (RM NCC RN 8.0 Chp 23, System Disorder)

Gastrointestinal Structural and Inflammatory Disorders: Care of an Infant Diagnosed with Myelomeningocele (RM NCC
RN 8.0 Chp 23, System Disorder)

Back 28

gastrointestinal structural and inflammatory disorders include GE RD, hypertrophic pyloric stenosis, Hirschsprungs disease, intussusception, appendicitis, and cleft lip and palate. during vomiting place the child on her side to prevent aspiration. The nurse will advise to offer small frequent meals.

Front 29

Acute and Infectious Respiratory Illnesses: Interventions for Fever (RM NCC RN 8.0 Chp 17, Therapeutic Procedure)

Back 29

acute and infectious respiratory illnesses can come from a variety of illnesses. Some risk factors include age, anatomy, season, and decreased immune system if a fever cannot be brought down a cooling blanket needs to be used. Upon discharge the parents they to be educated of respiratory distress signs and symptoms

Front 30

Communicable Diseases: Chicken Pox (RM NCC RN 8.0 Chp 36, System Disorder)

Back 30

communicable diseases can be obtained from airborne, droplet, or direct contact transmission. The nurse needs to follow strict airborne, droplet, and contact precautions for whomever has a communicable disease.Reye syndrome Because with the use of aspirin during a viral illness, do not give aspirin to a patient with the flu. Chickenpox can be spread from the first day up to six days after the lesions appear and usually is not transmittable after they have scabbed over.

Front 31

Head Injury: Interventions (RM NCC RN 8.0 Chp 14, Therapeutic Procedure)

Back 31

Open head injuries are at high risk for infection. Educate clients of proper safety such as helmets, equipment during sports, and seatbeltsas well as avoiding dangerous activities. If the nurses not sure if the spine is injured the patient should be stabilized until spinal cord injuries ruled out. The nurse must implementcertain actions to decrease intracranial pressure such as bed elevation of 30°, avoid movement, and keep the head of midline neutral position instruct client to avoid coughing and blowing of the nose.

Front 32

Hospitalization, Illness, and Play: Assisting with Invasive Procedures (Nursing Skill, RM NCC RN 8.0 Chp 10)

Back 32

While the child is in the hospital consider the family patients as well. Educate the patients on what to expect from procedures. Keep to a routine if possible. Play is very good for the young patients and lets them take their minds off their problems. Let the children play with age appropriate toys if possible.

Front 33

Meningitis and Reye Syndrome: Lumbar Puncture (Diagnostic Procedure, RM NCC RN 8.0 Chp 12)

Back 33

Meningitis is inflammation of the meninges. It is very similar to Reyes syndrome. THey can be mistaken for one another and diagnostic testing may have to rule one out. Lumbar puncture is used to test CSF. Best diagnostic test. The site is numbed with lidocaine and monitored for infection afterwords. The patient had to lay flat for 4-8 hours to prevent leaking.

Front 34

Oxygen and Inhalation Therapy: Suctioning (Nursing Skill, RM NCC RN 8.0 Chp 7)

Back 34

Health promotion of the adoloescent occurs between 12-20. This is another period of rapid change for males and females. Erikson states this period is identity vs role confusion because many are stepping into adult roles and may question what they want to become. Due to the cognitive changes it is a good time for education about health, nutrition, drugs etc., however this group is stubborn and may not listen well even though they comprehend.

Front 35

Seizures: Postictal Period (RM NCC RN 8.0 Chp 13, System Disorder)

Back 35

THere are three major catagories of seizures, generalized, partial, and unclassified. During Tonic-Clonic seizures a patient may stop breathing during or after the seizure and needs to be monitored for respiration's. During a seizure a nurse needs to protect the client from themself and possible others trying to use old fashioned techniques to save the tongue. Keep them side lying out of reach from objects and do not restrain. After the seizure assess the patient's vitals, neuro check, initiate seizure precautions, and document time of occurrence, time to stop, and time to reorientates.

Front 36

Growth Hormone Deficiency: Management (RM NCC RN 8.0 Chp 34, System Disorder)

Back 36

Growth hormone can cause problems with development. It is secreted by the pituatary gland. Risk factors incude tumors, trauma, surgery, hereditary, or idiopathic. Without treatment dwarfism may occur. Children receive a baseline check for height and weight to assess growth thoughout the years. Hypopituitarisn results in low GH

Front 37

Psychosocial Issues of Infants, Children, and Adolescents: Diagnostic Findings (Diagnostic Procedure, RM NCC RN 8.0
Chp 43)
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Back 37

Children can have man psychological disorders that can be difficult to diagnose. Some of these include depression, anxiety, substance abuse, eating disorders, behavior and autistic disorders. Some of the risk factors include genetics, biochemical, environmental, cultural, traumatic events and family tendencies.